Provider Demographics
NPI:1669146080
Name:CHYLINSKI, LAURALEE OWENS (AUD)
Entity type:Individual
Prefix:DR
First Name:LAURALEE
Middle Name:OWENS
Last Name:CHYLINSKI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:580 RITCHIE HWY STE I
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3926
Mailing Address - Country:US
Mailing Address - Phone:410-647-7795
Mailing Address - Fax:410-647-7795
Practice Address - Street 1:11002 MANKLIN MEADOWS LN STE 5
Practice Address - Street 2:
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-9315
Practice Address - Country:US
Practice Address - Phone:410-647-7795
Practice Address - Fax:410-647-7795
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01561231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01561OtherMD LICENSE